Operations Manager - Cancer Center

Bargaining Unit: Non Represented - Manager

Rate of Pay: 91,499 DOE Annually

Summary
Responsible for oversite for all cancer center support services for clerical activities of the Cancer Center related to the process of scheduling, reception, new patient referrals, and financial counseling while maintaining the highest level of customer service to Tahoe Forest Hospital System (TFHS) customers, internal and external.

Essential Duties and Responsibilities

• Responsible for oversite for all cancer center support services. Will provide leadership from an Oncology Business perspective to ensure optimal financial outcome for patients and TFHD.
• Oversight of Department Lead. Provides ongoing support for coaching, training and feedback for department staff members to elicit the best performance in the team. Support the discussion and initiation of disciplinary actions as needed in accordance with system policies.
• Leads efforts to optimize the Cancer Center Charge capture. Works with Executive Director, Managers, Physicians and Nurse Practitioner in the Cancer Center to establish and maintain best practices for accurate front-end demographic and insurance data capture, clinical documentation of services performed and collection of patient co-payments and balances. Monitor performance and provide regular feedback to ensure continuous improvement.
• Establish and monitor processes and workflows within the Cancer Center for all core functions that support the revenue cycle including CPT and ICD-10 coding, eligibility verification and denial claim review and follow any concerns through to quick resolution.
• On a daily basis monitors accounts receivable balances, aging, collections, billing backlog, third party reimbursement changes, denials and appeals, unbilled revenue, credit balances and coding issues.
• Works closely and collaboratively with the TFHD revenue cycle team for timely resolution of any discrepancies or billing issues.
• Develop and maintain Cancer Center policies and procedures that are appropriately adapted to the population while maintaining coordination with the TFHD revenue cycle team practices.
• Regularly reviews finance data and any opportunities with Executive Director and Medical Director
• Updates group regularly on regulatory, coding or insurance changes that will affect billing. Educates the providers and staff in person and or by email quickly on any changes so that the practice can maintain up to date and optimal billing.
• Ability to call the insurance payer groups directly to work on claim issue resolution when needed.
• Reviews all requests for refunds and adjustments and works with the finance team for approval.
• Personally, handles problem accounts as necessary to maintain excellent public relations and ensure maximum collectibles.
• Ensure sufficient internal controls to maintain integrity of all billing and collection activities.
• Serve as a supportive member of the clinic and system management team and regularly escalate any problems or barriers through chain of command.
• Ensure timely and accurate completion and understanding of reports
• In compliance with HIPPA respect and protect the confidentiality of all protected health information
• Effectively manage competing priorities and proactively utilize all available workplace tools and resources to complete job responsibilities in and effective and timely manner.
• Collaborate with cross-functional teams to promote effective communication and operational efficiency.
• Assists Executive Director in developing and administering Capital and Operating budgets.
• Works with the lead to ensure department compliance with HFAP, Title 22 guidelines and regulation laws.
• Works closely from an Oncology operations lens with TFHD hospitals and telemedicine programs.
• Assists with training other TFHD teams as needed to build knowledge depth in Oncology billing, coding and denials.
• Contribute to the creation of a positive team environment, and consistently demonstrate integrity, honesty, kindness, courtesy, cooperation and sensitivity toward patients and co-workers.
• Demonstrates System Values in performance and behavior.
• Complies with System policies and procedures.
• Other duties as may be assigned.

Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Supervisory Responsibilities
Carries out supervisory responsibility in accordance with the organization’s policies and applicable laws. Responsibilities include interviewing, hiring, training, assigning, coaching, counseling, and disciplining employees; administering scheduling systems; communicating job expectations; planning, monitoring, appraising, and reviewing job contributions; enforcing policies and procedures.

Minimum Education/Experience
Associate's Degree and/or two-year college or university or 3 or more years relevant experience

Required Licenses/Certifications
None

Other Experience/Qualifications

Required:

• Demonstrates strong knowledge of Oncology Auth and Billing practices for E/M and pharmacy
• Demonstrates knowledge of third party Oncology payers including Managed care, Medicare and Medicaid
• Experience in Oncology ICD-10 Coding
• Demonstrates strong knowledge of Oncology Denial resolution
• Three or more years of leadership experience in a Rural Oncology Outpatient support services environment with focus on revenue cycle or equivalent setting.

Preferred:

• Certified Professional Coder, CPC